Doğumsal anomalilerde plastik cerrahi tedavi

Congenital Anomalies

Some babies are born with a difference in their face, ears, hands or skin. This is often worrying for families. However, most congenital anomalies can be corrected, both in function and appearance, with treatment at the right time. In our clinic, we evaluate congenital anomalies and plan together with families whether treatment is needed and when the best time is. The conditions we treat most often are congenital hand anomalies and ear deformities in children.

In short: Congenital anomalies are structural differences that develop while the baby is growing in the womb. The congenital anomalies plastic surgery deals with most often are hand and finger anomalies, ear deformities, congenital moles and vascular birthmarks, and breast anomalies.

When function is not affected, surgery is usually planned when the child is older. Earlier treatment is needed when feeding, speech, hand use or circulation is affected. An initial evaluation in the first weeks after birth helps plan the timing correctly.

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What Is a Congenital Anomaly?

The face, ears, hands and other structures take shape in the first weeks in the womb. During this period, tissues may develop differently, may not develop at all, or may not separate from each other. This is how congenital anomalies form. Some are noticed on ultrasound during pregnancy, while others become apparent at birth or in the first months. Often no clear cause is found; some families have a similar history. Some anomalies can occur together with differences in other parts of the body. That is why it is important for your child to be evaluated by a pediatrician as well.

Hand Anomalies

Hand and finger anomalies are among the congenital anomalies most often treated by plastic surgery. The hand’s ability to grasp, hold and make fine movements develops rapidly in the first years. That is why the timing of treatment is especially important. Similar anomalies can also occur in the toes.

Webbed Fingers (Syndactyly)

Syndactyly is when two or more fingers are joined by skin or bone. It is most common between the middle and ring fingers. In surgery, the fingers are separated using pieces of skin called flaps, and the web space is recreated. If there is not enough skin, the missing part is covered with a skin graft. For simple syndactyly, surgery is usually planned at 12–18 months. Earlier surgery may be needed when the fingertips are joined or when fingers of different lengths are joined.

Extra Fingers (Polydactyly)

Polydactyly is having more fingers or toes than normal. On the hand, it is most common on the little finger side and the thumb. The extra finger may be attached only by a thin skin stalk, or it may be connected to bone and joint. Surgery can be done from 6 months of age. The aim is not only to remove the extra finger, but to make sure the remaining finger is straight, balanced and functional. We do not recommend tying off the extra finger with a thread so that it falls off.

Constriction Band Syndrome

Thin bands formed from the membrane in the womb squeeze a finger, hand or foot like a ring. In mild cases, there is only a groove in the skin. In severe cases, there may be swelling (lymphedema), fused fingers and loss of fingers. If the band is deep and impairs circulation, it is released early. In other cases, it is released in a planned way with the Z-plasty technique.

Congenital Trigger Thumb

Congenital trigger thumb is when the tip joint of the thumb stays bent and does not straighten. A small firm lump may be felt in the palm at the base of the thumb. Some cases improve on their own in the first years. If not, the narrowing in the tendon sheath is released with a small operation. There are also rarer anomalies, such as an underdeveloped thumb, cleft hand, and fingers that are short or overly large.

Ear Anomalies

Prominent Ears

Prominent ears stick out too far from the head. They usually occur because the fold in the ear (antihelix) has not developed enough or the ear bowl is large. Surgery is planned before starting school, usually around the age of 6; at this age the ear cartilage is mature enough and the child can understand the process. The surgery is done from behind the ear, and the scar stays behind the ear.

Ear Fold Deformities

This group includes three conditions: an upper edge of the ear folded inwards (lop ear), an extra fold in the ear (Stahl’s ear), and the upper part of the ear buried under the skin (cryptotia). In infancy, these can be corrected with molding. In older children, surgery to reshape the cartilage is needed.

Non-Surgical Correction in Newborns

In the first weeks after birth, the ear cartilage is very soft. Prominent ears and fold deformities noticed during this period can be corrected without surgery using special molds. The method is most effective in the first weeks, and its effect decreases as the months pass.

Accessory Ear (Ear Tag) and Preauricular Sinus

A congenital skin or cartilage bump (accessory ear, ear tag) or a small hole (preauricular sinus) may be present in front of the ear. An ear tag is usually removed with a simple operation. A sinus is only monitored if it does not become infected. If it becomes infected repeatedly, the entire tract is removed.

Sık görülen doğumsal el anomalileri: sindaktili, polidaktili, konstriktif band ve tetik baş parmak

Skin and Vascular Anomalies

Congenital Mole (Congenital Nevus)

These are moles present from birth. Large and giant ones need follow-up both for appearance and for the risk of melanoma later in life. Treatment is planned according to the size and location of the mole: it can be removed in stages, or a tissue expander or skin graft can be used.

Nevus Sebaceous

A yellow-orange, hairless patch present from birth, usually on the scalp. It can become thicker and rough in adolescence, and rarely a tumor can develop on it. For this reason, surgical removal before adolescence is usually recommended.

Hemangioma

The most common benign vascular tumor of infancy. It appears in the first weeks after birth, grows rapidly in the first months, and then slowly shrinks over the years. Most are only monitored. For hemangiomas around the eyes, nose and lips, those that ulcerate or those that grow rapidly, the first option is medical treatment managed together with the pediatrician. If excess skin or a scar remains after the hemangioma shrinks, it can be corrected with surgery.

Dermoid Cyst

Slow-growing congenital swellings, seen especially at the outer end of the eyebrow and on the bridge of the nose. Because they can grow over time and leave a mark on the bone, they are usually removed in childhood with a small operation. Those on the bridge of the nose can extend deeper, so imaging may be needed before surgery.

Breast and Body Anomalies

Tuberous Breasts and Breast Asymmetry

In tuberous breasts, the base of the breast is narrow, the lower part of the breast is underdeveloped and the area around the nipple looks puffy. In breast asymmetry, there is a noticeable difference in size or shape between the two breasts. These differences become apparent in adolescence. Corrective surgery is usually planned after breast development is complete.

Poland Syndrome

Poland syndrome is the congenital underdevelopment or absence of the large chest muscle on one side. The breast and nipple on the same side may be small, and the hand may have short or webbed fingers. Chest and breast reconstruction is usually planned in adolescence, when body growth is nearly complete. Implants, fat injection and tissue transfer (flap) methods can be used for reconstruction.

Nipple Anomalies

Congenitally inverted nipples and extra nipples along the chest–abdomen line (polythelia) are common nipple anomalies. Both can be corrected with short operations under local anesthesia.

Other Congenital Anomalies Treated by a Team

Some congenital anomalies require different specialties to work together. In these cases, treatment is planned together with pediatric surgery, neurosurgery, ENT, pediatric urology and dentistry.

Cleft Lip and Palate

This occurs when the lip and palate do not join in the womb. Lip repair is usually done at around 3 months, and palate repair between 9 and 18 months, before speech begins. Because it affects feeding, speech, teeth and ear health, treatment is carried out by a team.

Facial Clefts and Facial Asymmetry

In conditions such as rare facial clefts and underdevelopment of one side of the face (hemifacial microsomia), treatment is planned in several stages according to the child’s growth.

Head Shape Deformities

Early closure of the skull sutures (craniosynostosis) is usually operated on within the first year by a neurosurgery and plastic surgery team. A flat head caused by the baby always lying on the same side usually improves with position changes and, if needed, a helmet.

Absent or Underdeveloped Ear (Microtia)

Ear reconstruction is usually done after the age of 8–10, in several stages, using rib cartilage. An ENT evaluation is needed for hearing.

Vascular Malformations

Capillary birthmarks such as port-wine stains, as well as venous and lymphatic malformations, do not shrink on their own. Depending on the type, laser, sclerotherapy or surgical options are considered.

Hypospadias

In boys, hypospadias is when the urinary opening is on the underside of the penis. Repair is usually done between 6 and 18 months. Circumcision should not be done during this period.

How Does Treatment Work?

Some congenital anomalies are corrected with a single operation. Others are treated in several stages over the years as the child grows. When needed, we work together with the pediatrician, pediatric surgeon, neurosurgeon, ENT specialist, dentist, physiotherapist and other specialists.

In children, surgery is usually performed under general anesthesia by a team experienced in pediatric anesthesia. Before surgery, your child is evaluated for anesthesia. After minor operations, children usually go home the same day or the next day. After hand surgery, a splint or bandage is used for a few weeks; if needed, a hand therapy program is started. In a growing child, some conditions need to be monitored over the years. That is why regular check-ups are an important part of the result.

When Are Congenital Anomalies Treated?

Timing depends on how much the anomaly affects function, and on the child’s age and general health. Approximate timings:

First weeks: First examination; molding for ear deformities.
Early period: Release of constriction bands that impair circulation.
Around 3 months: Cleft lip repair.
From 6 months: Extra finger surgery.
Within the first year: Craniosynostosis surgery.
6–18 months: Hypospadias repair.
9–18 months: Cleft palate repair.
12–18 months: Simple webbed finger surgery.
Around 6 years: Prominent ear surgery.
After 8–10 years: Ear reconstruction for microtia.
Adolescence and after: Correction of breast and chest anomalies.

These timings are for general information. The best time for your child is decided at the consultation.

Frequently Asked Questions

At what age should surgery be done for congenital anomalies?

It differs for each anomaly. Cleft lip can be operated on at around 3 months, extra fingers from 6 months, simple webbed fingers usually from 12–18 months, and prominent ears before school, from around the age of 6. Earlier treatment is needed when feeding, circulation or hand use is affected.

If my baby has a congenital difference, when should we see a doctor?

In the first weeks after birth. Even if surgery will be done later, an early evaluation helps plan the timing correctly. For ear deformities, the first weeks also offer a chance of correction without surgery.

Are congenital anomalies hereditary?

Often no clear cause is found, and the chance of recurrence in later pregnancies is low. In some anomalies, however, there is a similar family history, or the anomaly may be part of a genetic syndrome. In these cases, a genetic evaluation is recommended.

Can an extra finger be tied off with a thread so that it falls off?

We do not recommend it. Even if the tied finger falls off, there is a risk of bleeding and infection, and a painful nerve ending or bump may remain. Removing the extra finger with the proper technique is safer.

Can prominent ears be corrected without surgery in infancy?

In the first weeks after birth, the ear cartilage is soft, so correction without surgery can be tried with special molds. The effect of this method decreases as the months pass. In older children, surgery is needed for a permanent correction.

Do hemangiomas go away on their own?

Most hemangiomas shrink over the years after the growth period in the first months and are only monitored. Hemangiomas around the eyes, nose and lips, or those that ulcerate, need early treatment.

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Cost of Congenital Anomaly Treatment

Because every child’s condition is different with congenital anomalies, it would not be right to give a single price. The cost is determined after the consultation, according to your child’s personalized treatment plan. The main factors that affect the cost:

The type and severity of the anomaly
The length of the surgery and the technique used
Whether additional procedures such as skin grafts or flaps are needed
Whether the treatment will be done in one operation or in several stages
The type of anesthesia and the length of the hospital stay
Dressings, splints and check-ups after surgery

Insurance: Whether private health insurance covers congenital conditions depends on the policy. If you have insurance in your home country, we recommend checking with your insurer before the surgery whether your policy covers this treatment in Türkiye.

Information and Booking

If your baby or child has a congenital difference, we recommend an early consultation, even if surgery will be done later. At the consultation, we evaluate your child and plan together with you whether treatment is needed and when the best time is.

Please bring with you to the consultation:

Any previous medical reports and discharge summaries
Imaging results such as X-rays or ultrasounds
A list of the medications your child takes

Before the consultation, you can send photos via WhatsApp for preliminary information. Photos only give a general idea; the definitive evaluation and treatment plan are made at the consultation. If you live abroad, this also helps us plan your trip and your stay in Türkiye.